Syphilis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Syphilis is a curable sexually transmitted disease caused by the Treponema pallidum spirochete. The route of transmission of syphilis is almost always by sexual contact, although there are examples of congenital syphilis via transmission from mother to child in utero. The signs and symptoms of syphilis are numerous; before the advent of serological testing, precise diagnosis was very difficult.

  • Hx number of sexual partners, condom use,
  • Hx of sexually transmitted disease, intravenous drug use, exposure to blood products

History and symptoms

The history and symptoms of syphilis according to the stage of disease are described below:[1][2][3]

Stage of syphilis History and symptoms
Primary syphilis
  • Onset within 3 weeks of contact.
  • Heals spontaneously within 4-6 weeks; however, regional lymphadenopathy may persist for longer periods.
Secondary syphilis
  • Develops 6-8 weeks after the appearance of primary chancre.
  • Generalized systemic symptoms such as malaise, fatigue, headache and fever may be present.
  • Skin eruptions may be subtle and asymptomatic.
  • Classic:
  • Non-pruritic bilateral symmetrical mucocutaneous rash
  • Non-tender regional lymphadenopathy
  • Condylomata lata
  • Patchy alopecia
Latent syphilis
  • Previous history of chancre or rash.
  • Asymptomatic
Tertiary syphilis
  • Clinical manifestation of this stage depends on organ system involved:

Neurosyphilis

Cardiovascular syphilis

Gummatous lesions

  • Presents with any organ system involved.
  • Nodular papular lesions in case of cutaneous gumma.

References

  1. Singh AE, Romanowski B (1999). "Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features". Clin Microbiol Rev. 12 (2): 187–209. PMC 88914. PMID 10194456.
  2. Carlson JA, Dabiri G, Cribier B, Sell S (2011). "The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity". Am J Dermatopathol. 33 (5): 433–60. doi:10.1097/DAD.0b013e3181e8b587. PMC 3690623. PMID 21694502.
  3. Wöhrl S, Geusau A (2007). "Clinical update: syphilis in adults". Lancet. 369 (9577): 1912–4. doi:10.1016/S0140-6736(07)60895-2. PMID 17560432.


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